Invisible Antimicrobial Glove and Hand Antiseptic

ABSTRACT

An alcohol based hand surgical scrub, which includes cationic anti-microbial agent preservatives, cationic polymer film-forming agents and a skin emollient, and provides a long term residual, anti-microbial “invisible glove” on the skin. The composition provides an immediate reduction in bacterial microbes. The polymer system creates an invisible film on the skin following solvent evaporation. This invisible film provides a lasting anti-microbial barrier on the skin which acts to prevent microbial growth.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. patentapplication Ser. No. 12/273,905, filed Nov. 19, 2008, which is acontinuation application of U.S. Pat. No. 7,488,757, issued on Feb. 10,2009, which is a national phase of PCT/US2004/009009, filed Mar. 24,2004, which claims priority from U.S. Provisional Application No.60/457,054, filed Mar. 24, 2003.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to an alcohol-based antiseptic surgicalscrub, which leaves an anti-microbial invisible film or “glove” on thehands, following alcohol evaporation.

2. Description of Related Art

Diligent hand washing and the wearing of gloves by healthcareprofessionals are essential components of effective infection control inthe healthcare environment. Healthcare professionals regularly washtheir hands and wear gloves to control the spread of bacteria andinfection from patient to patient, and to themselves.

Hand washing procedures are performed in several ways and includeproducts such as an ordinary anti-microbial bar soap, skin disinfectingor pre-operative agents or rubbing alcohol. Such procedures and productscontain anti-microbial agents such as alcohol, iodine, chlorhexidinedigluconate, chloroxylenol, triclosan and hexachlorophenes. Gloving bythe healthcare workers is a normal practice in the hospital setting tocreate a barrier that protects themselves and the patient fromtransmitted bacteria.

Healthcare workers commonly use scrub brushes impregnated withanti-microbial agents for antiseptic hand washing prior to surgicalprocedures and other invasive patient care procedures. These impregnatedscrub brushes have proven to be an effective method of reducing thespread of infection in the healthcare setting. Anti-microbial solutionsare specially designed for use in the scrub brush where the mechanicalaction of scrubbing with the brush creates a foam or lather. Beforeperforming a surgical procedure, the surgical team uses surgical scrubsto disinfect their hands with such a standardized scrub procedure,usually lasting 5 to 10 minutes, then don sterile gloves beforeinitializing the surgical procedure.

Alcohols, in general, are recognized for their disinfection properties.Rubbing alcohol, containing 70% ethyl alcohol (Formula 23-H) and 30%water, and isopropyl rubbing alcohol, containing 70% isopropyl alcoholand 30% water, are commonly used disinfectants. Alcohol is a potentanti-microbial agent, and, if used with surgical scrub, will causesignificant mean log reduction of bacterial counts on the hands ofhealthcare workers. However, the use of alcohols for surgical scrubs hasnever become popular in the United States of America, even though thecompound has very good properties for immediate reduction of microbialflora on the hands. This may be due to the fact that alcohol is adefatting agent. When applied to the human skin, it can make the skinvery dry, often leading to chapped and cracked skin. Thesecharacteristics thus often result in difficult and painful sensitivityfor the users.

The prior art includes many examples of varying antiseptic skin cleanersand wipes, some of which include alcohol. U.S. Pat. No. 4,678,606discloses a personal liquid cleaning composition having a primarysurfactant selected from the group of anionic, cationic, zwitterionic,amphoteric and semipolar surfactants, an auxiliary surfactant selectedfrom certain ethoxylated aliphatic alcohols and a water-solublepolymeric thickening agent. U.S. Pat. No. 4,374,126 discloses an alcoholinsoluble antimicrobial topical lotion including a lower acrylateinterpolymer. U.S. Pat. No. 5,512,199 discloses an antimicrobial handwipe which includes an alcohol. U.S. Pat. No. 6,180,584 is directed to afilm forming antimicrobial composition. Notably, this composition is analcohol-free anti- microbial skin sanitizing composition.

However, none of these prior art products provide the benefits of thepresently disclosed surgical scrub composition, which not only includesalcohol, but also provides the desired invisible, anti-microbiallong-lasting film on the hands following solvent evaporation.

SUMMARY OF THE INVENTION

The present invention is an alcohol based hand surgical scrub, whichincludes dual anti-microbial agent preservatives, cationic polymerfilm-forming agents and provides a long term residual, anti-microbial“invisible glove” on the skin. The composition desirably comprises analcohol, anti-microbial agent which prevents the growth of bacteria anda polymer system to form a barrier on the skin. The polymer systemcreates an invisible film on the skin following solvent evaporation.This invisible film provides a lasting anti-microbial barrier on theskin.

The composition desirably includes an alcohol, a positive chargedanti-microbial agent, skin emollients and lubricants and a film-formingpolymer system. The composition may also include one or both of methyland propyl parabens and silicone. The anti-microbial agents preventbacteria from growing back to the baseline of the normal skin florapopulation. The surgical scrub composition contains chemical ingredientsto remove extraneous matter and organisms from the hands. Skinemollients and lubricants are also provided to prevent the defattingeffect of the alcohol, thereby eliminating the dry, chapped feeling onthe skin. Additional or complimentary anti-microbial agents arepreferably included to serve as preservative and persistent activeagents. These anti-microbial agents in the composition will improve theanti-microbial characteristics of the formulation and provide along-term residual activity for the skin. As previously noted, thepolymer system is included to create an invisible film after the solventis evaporated. This invisible film acts as a physical anti-microbialbarrier or “glove” to protect the healthcare worker's hands. This filmhas an anti-microbial effect at least for six hours to prevent and killthe bacteria on the healthcare worker's hands.

BRIEF DESCRIPTION OF THE DRAWING

FIG. 1 is a graphical presentation of the log_(in) reductions frombaseline for the preferred formula and BD E-Z Scrub™ [BD Catalog#371073] plus the most preferred embodiment.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

This invention may be satisfied by embodiments in many different forms,and is not limited to any specific or preferred embodiments of theinvention, which are merely exemplary of the principles of theinvention. Various other modifications will be apparent to and readilymade by those skilled in the art without departing from the scope andspirit of the invention. The scope of the invention will be measured bythe appended claims and their equivalents.

The surgical scrub composition of the present invention includesalcohol, a positive-charged anti-microbial agent, skin emollients andlubricants, and a cationic polymer film-forming thickening agent.

One or more alcohols are utilized in the surgical scrub composition dueto alcohol's well known germicidal properties. Alcohols which may beused in the present composition include isopropyl alcohol, ethanol, andn-propanol. In the most preferred embodiment, ethyl alcohol is used.Preferably, alcohol is present in the surgical scrub composition in anamount from about 60 to about 95 weight percent, and most preferably, atabout 71 weight percent.

Emollients are utilized in the surgical scrub composition of the presentinvention to lessen the drying effect of the alcohol on the skin. Apreferred emollient is isopropyl palmitate, which is an ester emollientavailable from Amerchol Corporation of Edison, N. J. When used on theskin, isopropyl palmitate leaves a soft, non-sticky feel to the skin.Isopropyl palmitate is a lipophillic emollient, an oily, fatty substancewhich is water insoluble. Lanolin and its derivatives are a large groupof fatty materials with active emollient properties that can be utilizedas emulsifiers or lubricants in the composition.

The preferred embodiment includes glycerin as a hydrophilic emollientand a humectant to maintain the water in equilibrium. Glycerin isavailable from Spectrum Quality products. Glycerin is a water andalcohol soluble emollient that provides skin conditioning properties tothe composition. In another embodiment, propylene glycol may besubstituted for glycerin. Preferably, glycerin is present in thesurgical scrub composition, by weight percent of the entire composition,in an amount of from about 0.1% to about 5%, and most preferably, about1.4%.

The surgical scrub composition further includes a silicone fluid.Preferably, the silicone fluid is dimethicone copolyol, cyclomethiconeand dimethicone. Most preferably, dimethicone is utilized. Dimethicone350 is commercially available from General Electric Corporation.Silicone fluids provide good lubricating, aesthetic and occlusive actionon the skin. Silicone fluids not only lubricate the skin surface, theyalso act as a gas barrier to reduce water vapor transmission. Siliconefluids are water and gas insoluble. Preferably, the silicone fluid ispresent in the surgical scrub composition, by weight percent of theentire composition, in an amount from 0 to about 5%, and mostpreferably, about 0.03%.

Most hydrocarbons are derived from petrolatum crude by a fractionaldistillation process. Such hydrocarbons function as emollients due totheir ability to lubricate and hold water at the skin surface due totheir relative occlusivity. Mineral oil and isopropyl palmitate areincluded in the most preferred embodiment. Despite its lack of aestheticproperties, petrolatum may be utilized. Alternatively or additionally,lanolin derivatives may be included. Preferably, mineral oil is presentin the surgical scrub composition, by weight percent of the entirecomposition, in an amount from 0 to about 5%, and most preferably, about0.2%. Preferably, isopropyl palmitate is present in the surgical scrubcomposition, by weight percent of the entire composition, in an amountfrom about 0.1% to about 5%, and most preferably about 0. 4%.

Preferably, the surgical scrub composition includes about 0.1% to about5% of an emollient or emollients.

An anti-microbial agent is included in the surgical scrub composition tokill microorganisms and prevent or inhibit their growth andreproduction. In the absence of an antimicrobial agent, microbial florawill grow on the skin following alcohol evaporation. The antimicrobialagents present in the surgical scrub composition are selected to becompatible with the chemical and physical properties of the skin. Inaddition, the antimicrobial agent should be non-toxic andenvironmentally friendly.

As previously noted, the alcohol component of the surgical scrubcomposition is an excellent antimicrobial agent. It also acts as apreservative. However, following application of the surgical scrubcomposition, the alcohol will evaporate from the skin over time. In themost preferred embodiment, the residue remaining on the skin followingalcohol evaporation will include an amount of an antimicrobial agentwhich also acts as a preservative. Suitable antimicrobial agents whichact as preservatives may be selected from the class of phenols includingpara-chloro-meta-xylenol, bis-biguanides such as chlorhexidinedigluconate, chlorhexidine diacetate or quaterium class such asbenzethonium chloride, benzalkonium chloride. Chloroxylenol, triclosan,hexachlorophenes, octenidine and quarternary compounds may be included.Hexetidine, germaben II, which contains diazolidinyl urea, kathon CG,which contains methyl chloro isothiazoline and methyl isothiazoline,triclosan are other antimicrobial agents may also be suitable aspreservatives. Benzethonium chloride and benalkonium chloride (ashyamine 3500) are available from Lonza Inc., chlorhexidine digluconateis available from Xttrium Laboratories, germaben II is available fromSutton Laboratories. In a most preferred embodiment, benzethoniumchloride, chlorhexidine digluconate (20%) and benzelkonium chloride(80%) are present. Preferably, benzethonium chloride is present in thescrub composition, by weight percent of the entire composition, in anamount from about 0.05% to about 5%, and most preferably, about 0.09%.Preferably, chlorhexidine digluconate (20%) is present in the surgicalscrub composition, by weight percent of the entire composition, in anamount from about 0.05% to about 5%, and most preferably about 0.45%.Preferably, benzalkonium chloride (80%) is present in the surgical scrubcomposition, by weight percent of the entire composition, in an amountfrom 0 to about 5%, and most preferably, about 0.09%. Preferably, thecomposition includes about 0% to about 5% of an anti-microbial agent.

Methylparaben and propylparaben (both available from MallinckrodtChemical Company) are desirably included in the surgical scrubcomposition as preservatives. These are further desired for theirmoisturizing and film forming characteristics. Preferably, methylparabenis contained in the surgical scrub composition, by weight percent of theentire composition, in an amount from about 0 to about 5%, and mostpreferably about 0.03%. Preferably, propylparaben is present in thesurgical scrub, by weight percent of the entire composition, in anamount from about 0 to about 5%, and most preferably, about 0.03%. Oneor both of these compositions are preferably included in the amount ofabout 0% to about 5% of the surgical scrub composition.

To create the desired residual film of the surgical scrub composition,cationic polymer thickening agents are employed. Thickening agents mustbe soluble in the alcohol and compatible with cationic ingredients. Thecationic polymer thickening agents are preferably present in thesurgical scrub composition, by weight percent of the entire composition,in the amount of about 0.1% to about 5%.

Incroquat behenyl TMS is most preferably used as a cationic polymer. Itis a strong conditioning agent and an outstanding cationic emulsifier.This composition bonds to the skin due to the skin's negative charge.Incroquat behenyl TMS is a compound of 25% active solution of behenyltrimonium methosulfate in cetearyl alcohol and is available inflaked/pastel form and supplied by Croda Inc. Incroquat CR concentrateis preferably used as an additional cationic polymer. Incroquat CRconcentrate is available from Croda Inc. and is comprised of cetearylalcohol, castor oil and stearalkonium chloride. This composition is aone-part fonnulating aid. It is a conditioner and self-emulsifier. Thedesired combination of the incroquat behenyl TMS and incroquat CRconcentrate provides a smooth feel to the skin and neutralizes thestatic charge of the human skin. Preferably, incroquat BTMS is presentin the surgical scrub composition, by weight percent of the entirecomposition, in an amount from about 0.1% to about 5%, and mostpreferably about 0.4%. Preferably, incroquat CR is present in thesurgical scrub composition, by weight percent of the entire composition,in an amount from 0 to about 5%, and most preferably about 0. 1%.

Alternative or additional polymers include cellulose,polyvinylpyrolidone and waxes.

The most preferred embodiment of the surgical scrub composition is asfollows:

% of Total (w/w) 1-Docosanol 1.00% Benzethonium Chloride 0.09%Chlorhexidine Digluconate, (20%) 0.45% Dimethicone 0.03% Ethyl Alcohol71.00% Glycerin 1.40% Benzalkonium Chloride 0.09% Incroquat BTMS 0.40%Incroquat CR 0.10% Isopropyl Palmitate 0.40% Mineral Oil 0.20%Methylparaben 0.03% PEG-10 Behenyl Ether 1.50% Propylparaben 0.03%Purified Water 23.28%

The most preferred embodiment includes the additional components1-Docosanol as a moisturizer and film forming substance, PEG-10 behenylether as a moisturizer, fragrance and water. Preferably, 1-Docosanol ispresent in the surgical scrub composition, by weight percent of theentire composition, in an amount from about 0.1% to about 5%, and mostpreferably about 1%. Preferably, PEG-10 behenyl ether is present in thesurgical scrub composition, by weight percent of the entire composition,in an amount from about 0.1% to about 5%, and most preferably about1.5%. Preferably, purified water is present in the surgical scrubcomposition, in an amount from about 1% to about 35%, and mostpreferably about 23%.

The surgical scrub composition does not cause skin irritation orsensitization. Additional advantages of the composition include itscompatibility with positive-charged anti-microbial agents such aschlorhexidine digluconate, thus ensuring the effectiveness of theanti-microbial agent or agents. The included skin emollients andlubricants eliminate skin drying or chapping. These compositionscounteract the defatting effect of the alcohol.

The surgical scrub composition includes anti-microbial agents, which actas both persistent active agents and suitable preservatives. Thiscomposition permits a very small amount of an anti-microbial agent toimprove anti-microbial activities and provide long-term residualactivity for the skin.

Traditionally, healthcare workers have scrubbed prior to every surgicalprocedure. An improved method may be to apply water to the skin, performhand scrubbing at the beginning of the day using a scrub brush andanti-microbial scrub solution, rinsing the anti-microbial scrub solutionwith water, and then utilization of the composition of the presentinvention prior to subsequent surgical procedures. A high level of handantisepsis can be achieved via this method without abrasive scrubbingmultiple times a day.

EXAMPLES

The following examples are not intended to limit the scope of theinvention, but are only intended to be exemplary in nature.

Standard testing of the most preferred embodiment demonstrates itseffectiveness as an antiseptic to provide an immediate reduction ofmicrobes and then to prevent microbial growth back to baseline within a6-hour period. The immediate log reduction was 2.65 on day 1, 2.92 onday 2 and 3.04 on day 3. The residual effect was a log reduction sixhours after hand cleaning of 1.45 on day 1, 1.79 on day 2 and 2.18 onday 3. The residual anti-microbial activity is facilitated by thecontainment of the anti-microbial agent in the polymer film that isformed. The film forms an invisible “glove” containing an anti-microbialagent. The anti-microbial agent remains on the skin in the film andcontinues to be bactericidal over extended periods of time. Theinvisible glove prevents microbes that may be present on the hands ofthe healthcare worker from infecting a patient and the glove alsoprovides a barrier for microbes infecting the healthcare worker from thepatient.

Through testing, the composition has been shown to exceed industrystandards. The critical indices for this study were an immediate one (1)log₁₀ reduction in microorganisms on Day 1; an immediate two (2) log₁₀reduction in microorganisms on Day 2; an immediate three (3) log₁₀reduction in microorganisms on Day 5; and that microorganism populationsfrom the approximately three (3) hour to three (3) hour and thirty (30)minute AND approximately six (6) hour to six (6) hour and thirty (30)minute samples not return to baseline level. Refer to Table I.

TABLE I Statistical Summary of the Log₁₀ Recovery Values of MostPreferred Embodiment TFM Stan- Log₁₀ (1994) Sam- dard 95% ReductionRequired ple Devia- Confidence from Log₁₀ Sample Size Mean tion IntervalBaseline Reduction Baseline 36 6.01 0.40 5.88 to 6.15 N/A Day 1, 12 3.360.68 2.93 to 3.79 2.65 1 Immediate Day 1, 12 4.08 0.99 3.45 to 4.71 1.93No return 3 Hour to baseline Day 1, 12 4.56 0.68 4.13 to 4.99 1.45 Noreturn 6 Hour to baseline Day 2, 11 3.09 0.53 2.74 to 3.45 2.92 2Immediate Day 2, 11 3.73 0.90 3.12 to 4.34 2.28 No return 3 Hour tobaseline Day 2, 12 4.22 0.81 3.70 to 4.73 1.79 No return 6 Hour tobaseline Day 5, 10 2.97 0.47 2.63 to 3.31 3.04 3 Immediate Day 5, 113.50 0.61 3.09 to 3.91 2.51 No return 3 Hour to baseline Day 5, 11 3.831.01 3.15 to 4.51 2.18 No return 6 Hour to baseline

The most preferred embodiment was also tested in conjunction with astandard hand scrub utilizing a brush impregnated with an anti-microbialagent. The composition was applied to the hands of the test subjectone-half hour following the standard scrub. Test results showed anincreased log reduction of microbes when the scrubbing and the preferredcomposition were used together. Log reductions of microbes were 3.66 forDay 1, 3.98 for Day 2, and 3.70 for Day 3.

Use of the preferred composition in conjunction with a standard scrubexceeded industry standards for anti-microbial compositions. Refer toTable II and FIG. 1.

TABLE II Statistical Summary of the Log₁₀ Recovery Values Using BD E-ZScrub Catalog #371073 Plus Most Preferred Embodiment Sample TFM Stan-Log₁₀ (1994) Sam- dard 95% Reduction Required ple Devia- Confidence fromLog₁₀ Sample Size Mean tion Interval Baseline Reduction Baseline 38 6.100.38 5.97 to 6.22 N/A Day 1, 12 2.88 0.46 2.15 to 2.73 3.66 1 ImmediateDay 1, 13 3.13 0.79 2.65 to 3.60 2.97 No return 3 Hour baseline Day 1,13 3.79 0.88 3.26 to 4.32 2.31 6 Hour Day 2, 12 2.12 0.35 1.90 to 2.343.98 2 Immediate Day 2, 12 2.58 0.93 1.99 to 3.17 3.52 No return 3 Hourbaseline Day 2, 12 2.58 0.66 2.16 to 3.00 3.52 6 Hour Day 5, 10 2.290.37 2.02 to 2.55 3.81 3 Immediate Day 5, 10 2.28 0.32 2.05 to 2.51 3.82No return 3 Hour baseline Day 5, 12 2.40 0.49 2.09 to 2.71 3.70 6 Hour

What is claimed is:
 1. A surgical scrub composition comprising: (a) from 60% by weight (% wt) to 95% wt of the entire composition of one or more alcohols; (b) from 0.05% wt to 5% wt of the entire composition of a combination of one of chlorhexidine digluconate, benzethonium chloride, or benzalkonium chloride and one or more additional cationic anti-microbial agents; (c) from 0.1% wt to 5% wt of the entire composition of a skin emollient system including at least 1-docosanol and PEG-10 behenyl ether; (d) from 0.05% wt to 5% wt of the entire composition of a 25% active solution of behenyl trimonium methosulfate in cetearyl alcohol; and (e) a self-emulsifier, comprising cetearyl alcohol, castor oil, and stearalkonium chloride.
 2. The surgical scrub composition of claim 1, further comprising a silicone.
 3. The surgical scrub composition of claim 2, wherein the silicone includes one or more of the group of dimethicone copolyol, cyclomethicone and dimethicone.
 4. The surgical scrub composition of claim 1, further comprising one or more of the group of methylparaben and propylparaben.
 5. The surgical scrub composition of claim 1, wherein the additional anti-microbial agent is one or more of the group including chlorhexidine digluconate, chloroxylenol, parachloro-meta-xylenol, chlorhexidine diacetate, benzethonium chloride, benzalkonium chloride, hexetidine, diazolidinyl urea, methyl chloro isothiazoline, methyl isothiazoline, triclosan, hexachlorophenes, octenidine, and quaternary compounds.
 6. The surgical composition of claim 1, wherein the polymer system additionally includes one or more of the group including a stearalkonium chloride containing compound, cellulose, polyvinylpyrolidone and waxes.
 7. A method of disinfecting the skin comprising: (a) applying a surgical scrub composition to the skin prior to a surgical procedure, the surgical scrub composition including: i. from 60% by weight (% wt) to 95% wt of the entire composition of one or more alcohols; ii. from 0.05% wt to 5% wt of the entire composition of a combination of one of chlorhexidine digluconate, benzethonium chloride, or benzalkonium chloride and one or more additional cationic anti-microbial agents; iii. from 0.1% wt to 5% wt of the entire composition of a skin emollient system including at least 1-docosanol and PEG-10 behenyl ether; iv. from 0.05% wt to 5% wt of the entire composition of a 25% active solution of behenyl trimonium methosulfate in cetearyl alcohol; and v. from greater than 0% wt to 5% wt of the entire composition of a self-emulsifier; and (b) rubbing the skin with the composition until the alcohol has evaporated.
 8. A method of using a surgical scrub composition for hand antisepsis comprising: (a) applying a cleansing liquid to skin; (b) scrubbing the skin with an anti-microbial scrub solution; (c) rinsing the anti-microbial scrub solution from the skin; and (d) applying to the skin the surgical scrub composition according to claim
 1. 9. The method of claim 8, wherein the surgical scrub composition includes: the alcohol in an amount from about 60% wt to 95% wt of the total composition; the cationic anti-microbial agent in an amount from about 0.1% wt to about 5% wt of the total composition; the skin emollient system in an amount from about 0.1% wt to about 5% wt of the total composition; and the film-forming cationic polymer system in amount from about 0.1% wt to about 5% wt of the total composition.
 10. The method of claim 9, wherein the surgical scrub composition includes a silicone in an amount from about 0.1% wt to about 5% wt of the total composition.
 11. The method of claim 8, wherein the film-forming polymer system additionally includes one or more of the group including a stearalkonium chloride containing compound, cellulose, polyvinylpyrolidone and waxes.
 12. The method of claim 8, wherein the effective amount is 20cc.
 13. A surgical scrub composition comprising: (a) one or more alcohols in an amount from about 60% by weight (% wt) to 95% wt of the total composition; (b) one or more film-forming cationic polymers in an amount from about 0.1% wt to about 5% wt of the total composition, wherein the one or more film-forming cationic polymers include a behenyl trimonium methosulfate containing compound; (c) a combination of chlorhexidine digluconate, benzethonium chloride, and benzalkonium chloride in an amount from about 0.1% wt to about 5% wt of the total composition; (d) at least two skin emollients in a total amount from about 0.1% wt to about 5% wt of the total composition, wherein the at least two skin emollients include 1-docosanol and PEG-10 behenyl ether; and (e) a self-emulsifier.
 14. The surgical scrub composition of claim 13, further comprising from about 0.01% wt to 5% wt of a silicone.
 15. A surgical scrub composition comprising: (a) a preservative; (b) chlorhexidine digluconate and one or more additional cationic anti-microbial agents; (c) a film-forming system including a behenyl trimonium methosulfate containing compound, a self-emulsifier and further including at least one of the group containing glycerin, methylparaben or propylparaben; (d) from 60% by weight (% wt) to 95% wt of alcohol; (e) water; and (f) a skin emollient system including at least 1-docosanol and PEG-10 behenyl ether.
 16. A surgical scrub composition comprising: (a) from 60% by weight (% wt) to 95% wt of one or more alcohols selected from the group of ethyl alcohol, isopropyl alcohol, ethanol and n-propanol; (b) from 0.05% wt to 0.27% wt of chlorhexidine digluconate and one or more additional cationic anti-microbial agents selected from the group consisting of chloroxylenol, para-chloro-meta-xylenol, chlorhexidine diacetate, benzethonium chloride, benzalkonium chloride, hexetidine, diazolidinyl urea, methyl chloro isothiazoline, methyl isothiazoline, triclosan, hexachlorophenes, octenidine and quaternary compounds; (c) a skin emollient system including at least 1-docosanol and PEG-10 behenyl ether; (d) a film-forming cationic polymer system including a behenyl trimonium methosulfate containing compound and one or more selected from the group of cellulose, polyvinylpyrolidone, waxes, and stearalkonium chloride containing compounds; and (e) a self-emulsifier.
 17. The surgical scrub composition of claim 16, further comprising a silicone.
 18. The surgical scrub composition of claim 16, further comprising one or more of methylparaben or propylparaben.
 19. The surgical scrub composition of claim 1, wherein the composition comprises 0.09% wt chlorhexidine digluconate, 0.09% wt benzethonium chloride, and 0.09% wt benzalkonium chloride. 